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Why is He Abusive? Is His Brain Damaged or Something?
Studies have been done that have shown a direct correlation between suffering a traumatic brain injury (TBI) and becoming abusive. Read on ...
You may think the title of this entry was written tongue-in-cheek, but it wasn’t.
As unexpected as this may sound, I’m going to present you with a few facts which can be whittled down to one statement:
Brain damage can exacerbate a tendency toward domestic violence.
Numerous studies have been conducted that have shown a direct correlation to suffering a TBI (traumatic brain injury) and, as a result, becoming domestically aggressive.In one such study it was “found that head injury was significantly associated with domestic abuse, since the prevalence rate of head injury was considerably higher in the domestic abusers group compared to the other groups … They could also prove that in 93.1% of the cases of domestic abusers with head injury, the injury was prior to the abuse.”
Additionally, “the neuropsychiatric disturbances associated with TBI are numerous. They are generally observed to be disorders of mood, cognition, or behavior.”
Neuropsychiatrists Barry Fogel and A. Stone suggest that “head injuries, especially to the frontotemporal areas, can seriously erode inhibitory controls and affect your ability to figure out the meaning of an interpersonal event or your ability to read cues and develop an appropriate response.” What is particularly crucial to understand, since domestic abusers often tend to abuse substances as well, is that “if you have a history of head injury and you use alcohol or drugs, you are especially likely to have trouble with the neocortical function of your brain.”
Why have these studies shown that traumatic brain injury changes the personality of a person so much that he may become abusive?
First, it's been established that there are some inherent traits common to individuals who become abusive after TBI, such as a natural personality style of risk-taking and impulsivity. As Charles Symonds, an English neurologist and senior officer in the Royal Air Force, stated, “The response to head injury depends on the kind of head that was injured.”
Someone with a natural personality of impulsivity and risk-taking before a TBI may experience heightened and more dangerous forms of these impulses after the TBI.
Second, “certain neurological and neuropsychological deficits (especially those of the frontal and/or temporal lobe) can increase the potential for impulsive aggressive actions.”
The role of the frontal and temporal lobes, and how they can contribute to domestic abuse and aggressiveness, is crucial to understand.
Damage to the frontal lobe can result in depression, substance abuse, OCD, outbursts of anger and rage, and issues with comprehending or accepting the varying opinions of other people.
The frontal lobe regulates an individual’s personality, impulse control, sexual and social behaviors, and the ability to balance emotion in a healthy manner. Knowing this, it’s easy to see why someone suffering from TBI can suddenly or gradually change from an easy-going person who enjoys life and the fun aspects of risk-taking (think: wild roller coaster rides, car racing, skydiving, and other adrenaline-pumping activities) to someone who can’t regulate his emotions and who has become a “Dr. Jekyll/Mr. Hyde” personality.
After her husband suffered a TBI, medical professional Janet Cromer described him as having “volatile emotions [and] memory impairment.” He also blasted her with “verbal attacks, physical aggression and impaired impulse control … Sometimes his moods shifted so suddenly that I called it ‘Jekyll and Hyde syndrome.’ It was as if two different versions of Alan resided within him. One was rational and easy-going, but the other was frightening and even dangerous at times.”
Damage to the frontal lobe can also result in depression, substance abuse, OCD, outbursts of anger and rage, and issues with comprehending or accepting the varying opinions of other people.
The temporal lobe regulates the sense of smell and taste, behavior, communication issues, memory distortions (see my blog post about cognitive distortion), interpreting visual stimuli, and control of automatic and unconscious bodily reactions, such as the inability to know when you’ve had too much to drink (which inevitably exacerbates domestic abuse).
We again see here that a person with TBI may have problems communicating, may often believe his own distortions in memory, and may suffer from other regulation impairments—which are all hallmark traits of domestic abusers.
I spoke with a NeuroRehab specialist in Scarborough, Maine, as well as various professionals in the Raleigh, NC area, in order to validate these findings. All of these professionals confirmed that yes, there is a definite correlation between TBI and domestic abuse. I also spoke with a specialist in Deltona, FL, who confirmed that therapeutic intervention to increase self-awareness is possible and beneficial to a TBI sufferer who can also admit that he’s a domestic abuser, but it takes complete dedication, a lifelong commitment to change, and a thorough admittance of the issues that need to be addressed.
Lasting effects from a TBI can include rage-filled outbursts, irritability, problems understanding the perspectives of others, sleep issues, and noticeable personality changes (for example, a person who used to be an optimist becomes, after the TBI, far more pessimistic and less joyful).
It’s also crucial to note that if the TBI happens during childhood or adolescence, “he or she is likely to stop maturing emotionally beyond the age the TBI occurred.” In other words, if the brain injury happened when he or she was fourteen years old, he/she will be stuck in the emotional world of a teenager.
If your partner has ever experienced a TBI, seeing a neuropsychologist for a neuropsych evaluation could be of immense benefit.
Again, and as I so often repeat, there is no excuse for abuse. However, if your partner has ever experienced a traumatic brain injury, especially one that damaged his frontal and/or temporal lobes, and especially if he claims to have changed after his accident, seeing a neuropsychologist for a neuropsych evaluation could be of immense benefit.
If—and this is a huge if—he’s willing to listen to what you’ve discovered about TBI and if he’s willing to seek appropriate help, in all humility and determination to change his abusive ways, he could vastly improve his life (not to mention yours).
"Patients with traumatic brain injury are often referred to as 'the walking wounded,' because a number of them have persistent neuropsychiatric sequelae. Even though they appear physically 'normal,' they are disabled personally, socially, and occupationally. Ideally, treatment of these patients should involve a multidisciplinary approach, with the neuropsychiatrist working in close collaboration with the patient, family, neurologist/neurosurgeon, physiatrist, social worker, and the staff of community groups such as the local chapter of the brain injury association."
Esther Calvete, “Mental Health Characteristics of Men Who Abuse Their Intimate Partner,” https://scielo.isciii.es/pdf/sanipe/v10n2/revision.pdf; Kenneth Corvo, Ph.D., Jennifer Halpern, Ph.D., Richard Ferraro, “Frontal Lobe Deficits and Alcohol Abuse: Possible Interactions in Predicting Domestic Violence,” https://www.tandfonline.com/doi/abs/10.1300/J146v13n02_04; Alan Rosenbaum, Steven K. Hoge, Steven A. Alderman, William J. Warnken, Kenneth E. Fletcher, Robert L. Kane, “Head Injury in Partner-Abusive Men,” https://pubmed.ncbi.nlm.nih.gov/7860816/; Gordon Teichner, Charles J. Golden, Vincent B. Van Hasselt, Angela Peterson, “Assessment of Cognitive Functioning in Men Who Batter,” https://www.researchgate.net/publication/11451170_Assessment_of_Cognitive_Functioning_in_Men_who_Batter; American Association of Neurological Surgeons, “Traumatic Brain Injury,” https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Traumatic-Brain-Injury.
Esther Calvete, “Mental Health Characteristics of Men Who Abuse Their Intimate Partner.”
Vani Roa, M.D. and Constantine Lyketsos, M.D., M.H.P., “Neuropsychiatric Sequelae of Traumatic Brain Injury,” https://www.hopkinsmedicine.org/psychiatry/patient_information/bayview/docs/Neuropsychiatric%20sequelae%20of%20TBI.pdf.
David B. Wexler, Ph.D., When Good Men Behave Badly, 116.
Charles Symonds, “Mental Disorder Following Head Injury,” Proceedings of the Royal Society of Medicine 1937; 30:1081–1092, https://pubmed.ncbi.nlm.nih.gov/19991202/.
Janet M. Cromer R.N., LM.H.C., “After Brain Injury: The Dark Side of Personality Change, Part I,” https://www.psychologytoday.com/us/blog/professor-cromer-learns-read/201203/after-brain-injury-the-dark-side-personality-change-part-i.
Ibid. See also Brain Injury Institute, “Frontal Lobe Damage,” https://www.braininjuryinstitute.org/frontal-lobe-damage/ and Robert van Reekum, M.D., F.R.C.P.C., Tammy Cohen, B.A.(H), and Jenny Wong, B.A.(H), “Can Traumatic Brain Injuries Cause Psychiatric Disorders?”, The Journal of Neuropsychiatry, https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.12.3.316 and Vani Roa, M.D. and Constantine Lyketsos, M.D., M.H.P., “Neuropsychiatric Sequelae of Traumatic Brain Injury.”
Dan Brennan, M.D., “What You Need to Know About the Frontal Lobe,” https://www.webmd.com/brain/what-you-need-to-know-about-the-frontal-lobe; Cleveland Clinic, “Brain Lesions,” https://my.clevelandclinic.org/health/diseases/17839-brain-lesions; Spinalcord.com, “Temporal Lobe: Function, Location and Structure,” https://www.spinalcord.com/temporal-lobe; on alcohol abuse, see Dr. Christauria Welland, “Violence & Abuse in Catholic and Christian Families: Preparing an Effective and Compassionate Pastoral Response,” online course at https://health-transformations.learnworlds.com.
Angela Atkinson, “Traumatic Brain Injury (TBI) and Narcissistic Personality Disorder (NPD) Co-Morbidity.”
Vani Roa, M.D. and Constantine Lyketsos, M.D., M.H.P., “Neuropsychiatric Sequelae of Traumatic Brain Injury.”